| Trigger Finger |
Trigger Finger
This leaflet aims to tell you about the problem, the treatment options and the likely outcomes.
The first thing to understand is that this is not a serious or life threatening problem. For most people it is an irritation that interferes with certain functions of the hand although it can be painful.
Treatment is offered if the condition is painful or causing you significant problems.
What is it?
You will have noticed that your finger seems to be stiffer and on occasions locks down in the palm. This often happens when you first wake up in the morning. When you try to straighten the finger it is painful and the finger moves suddenly with a click.
You may have noticed a small swelling at the base of the finger which moves when you move your finger. This is a swelling on the guider (tendon) to the finger. At this point the tendon runs through a small tunnel attached to the bone, which can also become tight. When the tendon swells it sticks at the tunnel and the finger becomes stuck. We do not fully understand why the tendon swells.
Who gets it?
We do not know what causes trigger finger. It can occur at any age from babies to the elderly and affects both men and women. However some other conditions can increase your risk or make the disease worse:
• Diabetes
• Rheumatoid arthritis
• Very occasionally some jobs seem to be associated
What can I do?
There is no evidence that hand creams or other medication can slow down or cure the problem. We would recommend that you stop smoking, as this does not help healing. You do need to decide whether the problems you have are bad enough to require treatment.
Treatment
Some people with trigger finger manage without treatment. Treatment is offered for three reasons:
1. You are having major problems functioning because of the locking.
2. The finger has become stuck and no longer moves at all
3. The finger is very painful
There are various types of treatment available that your surgeon will discuss with you.
Conservative:
This means treatment without operation. Some people can be given a splint to wear at night time to prevent the finger becoming locked during the night. However most surgeons believe that the success rate of this treatment is very low.
Injections:
80%of patients can be successfully treated with a steroid injection into the finger or palm. There are two common techniques of injection that are equally effective. Which one is used depends on your physician’s preference and training.
Surgery:
Surgical treatment is generally simple, safe and quick. The surgery is generally performed under local anaesthetic as a daycase. You will have 2 or 3 sutures in your palm and a small bandage.
Postoperative care
The stitches will usually be removed after approximately 2 weeks.
Physiotherapy:
The vast majority of patients need no physiotherapy but a small percentage will benefit from supervised exercises to improve the function of the hand.
Complications
Incomplete release or recurrence:
Some patients who get an initial good result find that after a few months the stroid injection wears off and the problem returns. We can try a further injection but will usually offer an operation at that stage. Similarly after the operation some people find that the finger is slightly stiff.
Nerve damage:
In the hand the small nerves are always close to the tendons. Very occasionally some nerve damage can occur. (1 in a 1000)
Recurrence:
After steroid injection this is probably between 10 and 20%. After surgery this is probably 2-5%.
Infection:
A small proportion of patients will develop infection (more common in patients with diabetes) and require further surgery.
Reflex Sympathetic Dystrophy:
This is a condition that affects 1 in 1-2000 patients having hand surgery. The patients develop severe pain, swelling and stiffness in the hand. Despite treatment no patient will have a normal hand after this problem.
Despite this list of complications please remember that the vast majority of patients have an uncomplicated routine operation with a full recovery.
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